Sonnenfeld T, Cronestrand R
Acta Chir Scand. 1979;145(5):305-11.
Intra-operative measurement of leg blood flow is useful not only for the detection of a technical fault. It has also proved to be a sensitive method to disclose hypovolaemia. Thus, if the blood volume is not restored, the peripheral vasoconstrictor tone remains elevated. In such a state, the basal leg blood flow is low, but increases markedly on pharmacological vasodilation. In a normovolaemic situation, however, the basal blood flow is higher with a less pronounced increase following vasodilation. In the present study, intra-operative measurements of graft blood flow using an electromagnetic flowmeter have been employed to evaluate the blood substitution needed during 114 consecutive reconstructions with femoro-popliteal reversed saphenous vein bypass grafts. The measurements resulted in a blood transfusion therapy that was, on an average, 38% higher that it would have been, if substitution had been based simply on a calculation of blood losses from volume measurements in the suction apparatus and from the drapes and swabs. Only three graft thromboses developed within the first month. The flow rate of these grafts was much lower than the grafts remaining open. The low early thrombosis frequency (2.8%) compares favourably with previous reports, which might partly be explained by generous intra-operative blood transfusion.
术中测量腿部血流不仅有助于检测技术故障。它还被证明是一种检测低血容量的敏感方法。因此，如果血容量没有恢复，外周血管收缩张力会持续升高。在这种状态下，基础腿部血流较低，但在药物性血管舒张时会显著增加。然而，在血容量正常的情况下，基础血流较高，血管舒张后增加不明显。在本研究中，使用电磁流量计术中测量移植血管血流，以评估在114例连续的股腘静脉逆行大隐静脉旁路移植重建术中所需的血液补充。测量结果显示，与仅根据吸引装置中的容量测量以及手术巾和拭子上的失血计算进行血液补充相比，输血治疗平均高出38%。在第一个月内仅发生了3例移植血管血栓形成。这些血栓形成的移植血管的血流速度远低于仍保持通畅的移植血管。较低的早期血栓形成频率（2.8%）与先前的报告相比更具优势，这可能部分归因于术中大量输血。
